Shrake P D, Rex D K, Lappas J C, Maglinte D D
Department of Medicine, Indiana University Medical Center, Indianapolis.
Am J Gastroenterol. 1991 Feb;86(2):175-8.
Plain abdominal radiographs and enteroclysis studies were reviewed blindly in 117 consecutive patients undergoing enteroclysis for suspected small bowel obstruction. Plain radiographs were unreliably predictive of the presence of obstruction as determined by enteroclysis and surgery. Among patients with normal or abnormal nonspecific plain radiographs, varying degrees of small bowel obstruction were demonstrated by enteroclysis in 22%. Conversely, of patients with obstruction on plain radiographs, 42% had either normal enteroclysis studies or only minor adhesions. Enteroclysis correctly predicted the presence of obstruction in 100%, the absence of obstruction in 88%, the level (proximal vs distal) of obstruction in 89%, and the etiology of obstruction in 86% of operated patients. Enteroclysis is advocated as the definitive study in patients with clinical uncertainty about the diagnosis of small bowel obstruction.
对117例因疑似小肠梗阻而接受小肠灌肠检查的连续患者的腹部平片和小肠灌肠研究进行了盲法回顾。腹部平片对肠梗阻的预测不可靠，这是通过小肠灌肠检查和手术确定的。在腹部平片正常或异常但无特异性表现的患者中，22%经小肠灌肠检查显示有不同程度的小肠梗阻。相反，在腹部平片显示有梗阻的患者中，42%的小肠灌肠检查结果正常或仅有轻微粘连。小肠灌肠检查对手术患者肠梗阻的存在预测准确率为100%，无梗阻的预测准确率为88%，梗阻部位（近端与远端）的预测准确率为89%，梗阻病因的预测准确率为86%。对于小肠梗阻诊断存在临床不确定性的患者，提倡将小肠灌肠检查作为确定性检查。
